Elevated insulin‐like growth factor‐1 in Cushing’s disease
Copyright policy )Elevated insulin‐like growth factor‐1 in Cushing’s disease
SummaryObjectiveTo determine if patients with untreated Cushing's disease have higher serum insulin‐like growth factor‐1 (IGF‐1) compared to matched controls, and if IGF‐1 decreases following remission of Cushing's disease.DesignRetrospective case‐control study matching Cushing's disease cases to control patients for adenoma size, age, sex, diabetic and gonadal status, body mass index and serum IGF‐1 measured within one year. Paired analysis of pre‐operative (untreated) and >3 months post‐operative (remission) serum IGF‐1 for cases.Patients and measurementsAll patients were investigated at the Princess Alexandra Hospital Endocrine Unit between 2005 and 2017. Serum IGF‐1 was measured in 25 cases and 49 controls, 23 case‐control pairs and 13 cases pre‐ and post‐operatively.ResultsMean serum IGF‐1 in cases was significantly higher compared to controls—32 ± 12 nmol/L compared to 25 ± 8 nmol/L, (P = 0.005). The proportion of cases with elevated serum IGF‐1 above an age‐adjusted reference range was higher compared to 1:1 matched controls (8/23 (35%) vs 1/23 (4%), P = 0.02). In 13 cases in remission post‐operatively, serum IGF‐1 decreased significantly from 31 (IQR 29‐40.5) nmol/L to 23 (IQR 15‐28.5) nmol/L, (P < 0.001), despite no difference in the prevalence of pre‐ vs post‐operative pituitary hormone dysfunction (P = 0.47).ConclusionPatients with untreated Cushing's disease may have elevated IGF‐1, which decreases following remission. Mildly elevated IGF‐1 in Cushing's disease does not imply pathological growth hormone (GH) excess.
- University of Queensland Australia
- Princess Alexandra Hospital Australia
- University of Queensland Australia
- University of Queensland Australia
Adult, Male, insulin-like growth factor 1, glucocorticoids, pituitary diseases, 610, cortisol, Middle Aged, 1310 Endocrinology, Body Mass Index, Diabetes and Metabolism, 2712 Endocrinology, Pituitary Hormones, Adrenocorticotropic Hormone, Case-Control Studies, Growth Hormone, Humans, Cushing's disease, Female, Insulin-Like Growth Factor I, Pituitary ACTH Hypersecretion, Retrospective Studies
Adult, Male, insulin-like growth factor 1, glucocorticoids, pituitary diseases, 610, cortisol, Middle Aged, 1310 Endocrinology, Body Mass Index, Diabetes and Metabolism, 2712 Endocrinology, Pituitary Hormones, Adrenocorticotropic Hormone, Case-Control Studies, Growth Hormone, Humans, Cushing's disease, Female, Insulin-Like Growth Factor I, Pituitary ACTH Hypersecretion, Retrospective Studies
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